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Antidepressant medication adherence via interactive voice response telephone calls
Terri Castle1, Michael A Cunningham, Gary M Marsh
1Quality Management Department, Highmark, Inc, Pittsburgh, PA, USA.
The American Journal of Managed Care
|September 27, 2012
Summary
Interactive voice response (IVR) calls showed minimal impact on antidepressant medication adherence. Adherence significantly increased with patient age, suggesting a need for targeted strategies for younger individuals.
Area of Science:
- Health Services Research
- Behavioral Health
- Pharmacoeconomics
Background:
- High rates of antidepressant discontinuation occur among outpatients within the initial months of treatment.
- Improving medication adherence is crucial for effective management of depression and other mental health conditions.
Purpose of the Study:
- To evaluate the effectiveness of Highmark's interactive voice response (IVR) system in enhancing antidepressant medication adherence.
- To assess the impact of different levels of IVR engagement on adherence rates.
Main Methods:
- A quasi-experimental cohort intervention study involving 39,020 members newly prescribed antidepressants.
- Intervention groups were based on IVR call outcomes at one month: not reached, reached but not transferred to a depression management consultant (DMC), and reached and transferred to DMC.
- Medication adherence was assessed using Healthcare Effectiveness Data and Information Set (HEDIS) measures at 3 and 6 months, analyzed with generalized estimating equations.
Main Results:
- Medication adherence significantly increased with age, with individuals over 65 showing substantially higher odds of compliance compared to those aged 18-24.
- Initial analysis indicated improved adherence for members reached by IVR (groups 2 and 3) compared to those not reached (group 1).
- However, after adjusting for age, the positive impact of IVR intervention on adherence became statistically insignificant.
Conclusions:
- Interactive voice response (IVR) calls demonstrated a limited effect on improving overall antidepressant medication adherence.
- Age emerged as a significant factor influencing adherence, with older patients exhibiting notably higher rates.
- Future interventions aimed at improving antidepressant adherence should prioritize strategies tailored to younger patient populations.
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